Steroid drugs, a common treatment for young children prone to wheezing and colds, do not help and may even be harmful, according to new research. Wheezing, a high-pitched whistling noise made as a person exhales, occurs when air struggles to get through narrowed airways. It's a frightening symptom that often sends parents to emergency rooms, thinking their kids can't breathe. Hospitals commonly give such children steroids to open up airways. That's a standard treatment for adults and for children who have asthma, but its effectiveness for children with transient wheezing is unknown.
British preschoolers who were hospitalized with a wheezing attack and treated with the steroid prednisolone stayed just as long as other children who were given dummy pills. In Canada, children who had previous wheezing trouble and who took the steroid fluticasone as a preventive measure showed modest improvement, but the side effect of possible stunted growth outweighed the benefit, researchers said. Both studies are reported in today's New England Journal of Medicine.
"It is disturbing to contemplate how many unnecessary courses of prednisolone have been given over the years, in good faith, because we all assumed that preschool children are little adults," Dr. Andrew Bush of the Royal Brompton Hospital in London wrote in an editorial in the New England Journal of Medicine. Pediatrician Sami Bahna of the Louisiana State University Health Sciences Center in Shreveport said wheezing children who do not have asthma will be better served by a wait-and-see approach. "The majority will do well without intervention," Bahna said.
Behind the research
The study was funded by GlaxoSmithKline PLC, which makes Flonase nasal spray, a brand of fluticasone. The lead author, Dr. Francine Ducharme of the University of Montreal, reports receiving research grants from Glaxo and other drugmakers. The British research was paid for by the nonprofit Asthma UK. Several authors report receiving fees and support from various drugmakers that make asthma medication.